What is Glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve, which is crucial for vision. This damage is often caused by abnormally high pressure in the eye (intraocular pressure), leading to progressive vision loss. If untreated, glaucoma can lead to blindness. Early detection and treatment are key to preventing serious vision impairment.

Types of Glaucoma

There are several types of glaucoma, with the two most common being:

1. Primary Open-Angle Glaucoma:
   This is the most common form of glaucoma, where the drainage canals in the eye become clogged over time, leading to increased eye pressure. It develops slowly and often has no early symptoms, making regular eye exams essential for detection.

2. Angle-Closure Glaucoma:
   In this type, the iris (the colored part of the eye) is pushed or pulled forward, blocking the drainage angle and causing a sudden increase in eye pressure. This is a medical emergency and requires immediate treatment to prevent permanent vision loss.

Other forms of glaucoma include normal-tension glaucoma, secondary glaucoma (caused by another condition), and congenital glaucoma (present at birth due to abnormal eye development).

Causes of Glaucoma

Glaucoma is primarily caused by increased intraocular pressure, which can occur due to a blockage or malfunction of the eye’s drainage system (trabecular meshwork), leading to fluid buildup. Factors that may increase the risk of developing glaucoma include:

• Age: People over 60 are at a higher risk.
• Family History: A family history of glaucoma significantly increases the likelihood of developing the condition.
• Race: African Americans, Hispanics, and Asians are at higher risk.
• Medical Conditions: Conditions such as diabetes, high blood pressure, and heart disease can increase the risk of glaucoma.
• Eye Injuries: Trauma to the eye can lead to secondary glaucoma.
• Prolonged Use of Steroid Medications: Extended use of corticosteroid medications can elevate intraocular pressure.

Symptoms of Glaucoma

Glaucoma is often called the "silent thief of sight" because it can progress without noticeable symptoms until significant damage has occurred. However, some symptoms to watch for include:

• Gradual Loss of Peripheral Vision: In open-angle glaucoma, vision loss typically begins at the edges of the visual field (peripheral vision) and progresses slowly.
• Tunnel Vision: In advanced stages, vision may narrow, creating tunnel vision.
• Eye Pain or Redness: More common in angle-closure glaucoma.
• Sudden Onset of Blurred Vision or Halos Around Lights: Symptoms of angle-closure glaucoma.
• Nausea or Vomiting: Can accompany severe eye pain in acute cases of angle-closure glaucoma.

Diagnosis of Glaucoma

Glaucoma is diagnosed through a comprehensive eye exam, which includes the following tests:

• Tonometry: Measures intraocular pressure to detect elevated eye pressure.
• Ophthalmoscopy: Examines the optic nerve for signs of damage.
• Visual Field Test: Checks for peripheral vision loss, a common early sign of glaucoma.
• Pachymetry: Measures the thickness of the cornea, as corneal thickness can affect eye pressure readings.
• Gonioscopy: Examines the drainage angle of the eye to determine if it's open or closed.

Treatment for Glaucoma

The goal of glaucoma treatment is to lower intraocular pressure to prevent further damage to the optic nerve. Treatment options include:

1. Medications: Prescription eye drops are often the first line of treatment. These drops reduce eye pressure either by decreasing the production of fluid in the eye or by improving its drainage.

2. Laser Therapy: Laser treatments like laser trabeculoplasty or laser iridotomy are used to improve fluid drainage in the eye, helping to lower pressure.

3. Surgery: In cases where medications and laser therapy are not effective, surgical procedures may be necessary. These include trabeculectomy (creating a new drainage pathway for fluid) or implantation of a drainage device.

4. Minimally Invasive Glaucoma Surgery (MIGS): A newer approach that involves less invasive techniques to reduce eye pressure with fewer complications and faster recovery times.

Preventing Vision Loss from Glaucoma

Although glaucoma cannot be cured, vision loss can be slowed or prevented with early detection and proper treatment. Steps to reduce the risk of vision loss include:

• Regular Eye Exams: Early detection is crucial for managing glaucoma. Adults over 40, particularly those at higher risk, should have comprehensive eye exams every 1-2 years.
• Control of Medical Conditions: Managing conditions like diabetes and high blood pressure can reduce the risk of glaucoma.
• Exercise Regularly: Physical activity may help lower eye pressure.
• Protect Your Eyes: Wearing protective eyewear can prevent trauma that could lead to secondary glaucoma.